Headaches

What is a headache?

Headache is a very common painful disorder. Headache is the common medical term for headache. The term migraine refers to a very specific form of disabling headache, which is very common in the population. The diagnosis of headache is one of the most extensive in medicine with more than 200 different types and causes. Headaches are divided into primary forms, i.e. when they are the disease itself, and into secondary forms in which the headache is a warning symptom, a sign of an underlying disease (infectious, vascular, traumatic, metabolic, etc.). The main forms of primary headache, which account for more than 90% of cases, are migraine, tension-type headache and cluster headache.

Causes

Primary headaches, unlike secondary headaches, have no underlying cause. The brain of migraine
sufferers, for example, is absolutely identical to that of all other people, but it is particularly sensitive to any situation of increased energy demand. Many triggering factors therefore act on a 'special brain'.

Diagnosis

Diagnosis of primary headaches is mainly clinical, based on the collection of the patient's history. There is as yet no biological marker that allows a diagnosis to be made. The routine use of examinations (radiological, CT or MRI or other) is not justified in the case of a primary headache. The headache should be well described to the doctor, who is able to recognise clinical alarm bells for which investigations should be performed to exclude a secondary headache.

Possible therapies

There is unfortunately no therapy that will make headaches disappear completely for good. In the case of migraine attacks, it is essential that treatment is taken as early as possible (at the onset of pain), with the aim of controlling the pain and associated symptoms (nausea, vomiting, etc.) within 2 hours of treatment. In the case of frequent headaches, preventive treatment is indicated, which may be pharmacological or non-pharmacological (such as acupuncture, biofeedback, cognitive-behavioural therapies). The aim is to reduce the frequency, intensity and duration of attacks to improve quality of life and reduce the use of analgesics. Often it takes time to achieve these results: there is no ideal treatment for everyone, each of us has an individual response to medication.

It is estimated that about 50% of the world's adult population has a headache at least once in the last year. Among these at least 12% suffer from migraine and 2% from a chronic recurring headache at least 15 days a month. In Italy, 6 million people struggle with headaches. Migraine is very frequent in women of childbearing age (16-18%) and is considered by the World Health Organisation to be one of the most disabling diseases, i.e. capable of interfering with the quality of daily life, with high social repercussions in terms of direct and especially indirect costs due to loss of working days and reduced productivity at work.

The Headache Centre

Directed by Prof. Pietro Cortelli, the ISNB centre is a regional reference centre for headache treatment. Founded in 1980 by Prof. Elio Lugaresi, the centre is one of four in the Emilia-Romagna region for botulinum toxin therapy and a regional reference centre for neurosurgery for drug-resistant headaches.
The centre treats 1,000 new cases each year, mostly people with high-frequency headaches or rare forms with high diagnostic complexity. The centre provides personalised therapies and suggestions to be followed for maximum benefit. Implantation of a neurostimulator of the great occipital nerve is reserved for the most difficult and drug-resistant cases of cluster headache. The centre collaborates with other regional and national headache centres. The centre hosts trainees and thesis students of the degree course in Medicine and Surgery and postgraduates of the specialist training course in Neurology at the University of Bologna.

Contact

To book a visit*
Tel.: 051-496.69.90 (Ambulatori Neuroscienze IRCCS-ISNB)
Mail: ambulatori.irccs@ausl.bo.it
Fax: 051/4966098

*N.B.: In the case of headaches, the initial assistance is the prerogative of the general practitioner, who in collaboration with the local neurologist can, when necessary, schedule instrumental examinations (such as CT scans or MRI scans of the brain) to clarify the diagnosis and then set up an appropriate therapy and begin a phase of observation and follow-up of therapeutic intervention. When it is not possible to make a definite diagnosis, when the headache is complicated by the overuse of analgesics or does not respond to the previously prescribed therapies, or in the case of cluster headaches or other rare headaches, it is advisable to refer to a Headache Centre. A diagnostic and therapeutic pathway (PDTA) is in place for the inhabitants of the Bologna area, thanks to which the most serious patients are sent directly to the centre by their consulting neurologist for a neurological examination booked through CUP.

Opening hours/days
Monday to Friday from 9 a.m. to 1 p.m.

Sede

via Altura 3, BolognaPadiglione
F (Ospedale Bellaria), floor -1

Our professionals

Pietro Cortelli, neurologist and director of the Centre

Sabina Cevoli, neurologist
Giulia Pierangeli, neurologistValentina
Favoni, neurologist

Research

The Centre's research activity is aimed at studying the physiopathological and genetic bases of the main forms of primary headache. Particular attention is paid to the study of clinical, psychological, diagnostic and therapeutic aspects of headaches and their chronicity.
Finally, the centre participates in national and international clinical studies for the development of new therapeutic strategies.